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02/21/2013 07:42 253-E�31-�754 F'E'O�JIGENT E�_�CTFIC °�;5= 0�'!04 <br /> —_' —� <br /> I <br /> ELECTRICAL PERMIT APPLICATION I <br /> CITY OF EVERETT PERMfT SERVICES I <br /> ....... ... ... ... .....�. . .-..-... .-f ... . .,.,.�. , <br /> nnc �c+ ao �n cnv ��c �c-� cac� ..r-••• •+•..�•..u.•... ..,.� ., <br /> ._ —— __—_ __ . ___ _— __ -_ <br /> � . . _ _ _ . __ _ ._ __ . _ ___. � <br /> AYPUC/�TIOMi ARi ACCGPTGD YROM t hM TO•I PM I <br /> 99C�1 �,�_r�''L GJ _ � <br /> PROJECT ADDRESS <br /> ����o�K�o�++�s �3oxL�`��_►v�; Gc�cic _ C�/`18QaZ y25-ZC�S-9 Il_ <br /> Gv✓ner hlailAtltlress Ci,y StateRip ?hone <br /> ._--_—'— __ ' I <br /> Tenant tdall Atltlress City StafeJLip Phorx! ' <br /> '��u;��_Gl�.Er�c_1-�_�2�7_6�ZG��� G��1/9trnyZ Zss-fe�f-77� <br /> EleGtncal CCnlrer.l0� Mail Atldrvss Ory Stat0/2ip Pnone . <br /> ; t�,� V�5�f.-s.���� - -- --- - �f7� 7g2 I <br /> iom�e i mix �uw ei oN act 1'nce otTitio�(c- <br /> i � �if10��Y _ �jiuv� �'lid�� ------ �I <br /> IPropOsetl Usc of�C. ding Contact Person (Plan Review; i <br /> � Description of Work to Be D�,�ne. (iC�I,J Q.✓�P ��_y��_].r.�d. �r� �� - � <br /> � � <br /> � _ $.�o�-�'��1�t�i�� — <br /> � � <br /> i — <br /> FEE �� � <br /> NOTE: WIRING IN NON-0WELLINGS IS RE�UIR[D TO �j <br /> BE IN RACEWAYS, MC OR AC CABLE. — QO ��� � <br /> I i <br /> CITY OF EVERETT LOCAL SAlES TAX CODE�S 3105 <br /> � f hereby ceriily tha;!have reatl ond examined fhis applica;ion end knovi the same fo be true antl �� � �('�1 � I � � � � <br /> correct AU prowsians oI(a�vs and ordinancvs 9ovem;ng fhis type ol v�ork wil!ba mmplQted <br /> whelher specifietl h��em or noL The grantinq of a pr-rmi'does notp resume to grve autborrty�to � <br /> vmlate or cancel the provi;ions o!any other state or local law regufafing constrUCLon or the <br /> peAolmence o/consfnia7on. That 1 am authodzed bylhe o�rnor of thisp ropoRy to Dedo�m the <br /> �vork lor e;hich 2pplication is made and I comply�a�ith the Sfate Con:reclors Law 18 27 RCW end <br /> 706 200 Wi1C <br /> � FEB 2 0 2013 <br /> ` <br /> I� � S�nna;u;e ' __ _ . � Daie --- <br /> � <br /> i <br />